In our work on a large amount of clinical material, covering 645 patients with malignant tumors of the pancreas and periampullary region who underwent radical surgery: 149 extended resections and 496 standard resections of the pancreas, studied the possibility of performing extended pancreatic resections in patients with locally advanced pancreatic cancer. The diagnostic possibilities of modern methods of examination of patients was studied, the diagnostic algorithm was developed. The immediate and long-term results of standard and extended surgical interventions were analyzed. The main risk factors for postoperative complications were studied and identified, and measures to prevent them were developed. It was found that the presence of sarcopenia significantly (χ2=12,1, p=0,0005) increases the number of postoperative complications by 28,4 % and significantly affects the occurrence of postoperative pancreatic fistula (χ2=9,9, p=0,0017) and severe postoperative complications of grade 4–5 according to the Clavien Dindo classification. New methods and improved existing methods of performing extended pancreatic resections have been developed. It is proved that extended pancreatic resections are comparable in their results with standard pancreatic resections, and their wide application provided an increase in the total number of radically operated patients by 23,0 %, without a significant increase in the number of complications and mortality. Developed diagnostic and treatment tactics allowed to reduce significantly the level of postoperative complications after extended pancreatectomy from 47,9 to 31,6 % (χ2=4,1; p=0,04, p<0.05) and reduce mortality from 5,5 to 1,3 % (χ2=1,99; p=0,15, p>0,05). By increasing the number of extended pancreatic resections, improving treatment tactics, predictive techniques and measures to prevent postoperative complications and mortality, we achieved an increase in the median survival of patients with locally advanced pancreatic tumors from 15 to 22 months (χ2=2,5, p=0,1) and five-year survival from 20,0 to 25,5 % and the median survival in patients with tumors of the body-tail of the pancreas from 15,5 to 25,0 months (χ2=0,2, p=0,6) and a five-year survival rate from 16,4 to 24,5 %.
